In sad news, a 17-year-old boy in Mexico has died after suffering a stroke believed to be caused by a hickey his girlfriend gave him. Julio Macias Gonzalez had convulsions while eating dinner with his family in Mexico City after spending the evening with his girlfriend, Hoy Estado de Mexico reports. Gonzalez’ family called paramedics for help, but tragically, the boy later died. Medics say they believe his death was caused by a blood clot that developed from the hickey and traveled through his bloodstream to his brain, where it caused a stroke.

It sounds far-fetched, but this has happened at least once before. A 44-year-old woman from New Zealand suffered a non-fatal stroke after receiving a hickey, which was documented in a 2010 case study published in New Zealand’s Medical Journal. In the paper, researchers called the incident a “rare phenomenon.”

Richard Wright, M.D., a cardiologist at California’s Providence Saint John’s Health Center, tells SELF that this kind of thing is "incredibly rare." Lee Schwamm, M.D., stroke service director and executive vice chair of Massachusetts General Hospital’s Neurology Department, agrees, telling SELF that this is the first he’s heard of someone dying from a hickey-related stroke. However, he says, if a young person does have a stroke, it's quite common for it to happen because of an injury to the carotid artery.

The carotid artery is an important blood vessel that brings blood to your brain and face, and you have one on each side of your neck, Schwamm explains. The inner lining of the wall of the artery can get torn, in what’s known as a “dissection,” and a blood clot can form at the site of the tear. Blood rushing by can push that clot along, where it can go to your brain and cause a stroke.

While a stroke caused by an injury to the carotid artery can occur due to blunt trauma, like a car accident or punch, Schwamm says everyday occurrences can also cause the condition. “I’ve had patients who have had it happen from tilting their head back to do a shot, sneezing, turning their head quickly in the car to back it up, or going to the chiropractor,” he says. It can also happen when you're having your hair shampooed at a salon, which is known as beauty parlor stroke syndrome.

But it's not like you should cease any activity that could potentially harm your carotid, says Schwamm: “There’s some perfect storm that leads to this.” Clearly, people do these things every day and don’t have an issue, and Schwamm says experts aren’t totally clear why it happens to some people in some situations and not others, other than that someone may simply be genetically predisposed to a carotid artery injury.

However, doctors do know the signs that something is off with your carotid artery. You may experience severe pain on the side of your neck that's injured, pain shooting up from your neck to your brow toward your eyeball, a migraine, or a seizure, Schwamm says.

There are also signs that you’ve had a stroke, Wright says. They follow the acronym FAST: Your face is uneven or droopy on one side, one arm is weaker than the other, and your speech is slurred or you have difficulty understanding what someone is saying. "Then, it’s time to call 911," Schwamm says. "Every minute counts."

While it’s scary to know people have had strokes from hickeys, experts say you shouldn’t freak out. “Every day on the planet there are plenty of hickeys going on, and no one is having a stroke from them,” says Schwamm.